Better health-care training, tighter wildlife regulations needed

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BEIJING — A team of WHO and U.N. investigators said Thursday the Chinese government must tighten regulations on wildlife trade and train health-care workers if the disease is to be controlled permanently.

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The team of U.N. and World Health Organization investigators and Chinese government officials toured Guangdong, the province on the southern Chinese coast where the disease first surfaced, this month in part to search for the “animal reservoir” — the wild animal population where the virus is thought to have originated.

Severe acute respiratory syndrome hit Beijing the hardest of any city in the world. In China, of the 53-hundred cases, 349 were fatal. Half of those were in Beijing.

Many health officials believe SARS jumped from wildlife to humans in Guangdong, where consuming exotic creatures is a traditional practice and considered a delicacy.

In May, at the height of the outbreak, China banned the sale and trade of 54 types of wildlife — including the weasel-like civet cat, which was identified as a carrier of the SARS virus. This month, the ban was lifted for those species, as long as they are farm-raised, causing concern among international health officials.

The initial cases of what became known as severe acute respiratory syndrome were reported in Guangdong, and the disease quickly spread. More than 800 people around the world died of SARS, most of them in Asia, before it subsided in June.

WHO considers determining how SARS “first breached the species barrier” as a crucial goal, if not the most immediate one, said members of the team, who returned from the region last week.

“This is going to be a complicated, long-term project,” Dr. Hume Field, an Australian veterinary expert, said at a news conference. “We’ve got a jigsaw here, and we’re looking to identify the pieces and put them together until we get a picture that we can recognize.”

Dr. Pierre Formenty, a WHO physician and co-leader of the mission, said the team recommended China involve international scientists in research and collaborate with labs around the world, as well as work to standardize labs and methodology.

“Finding its origin will most likely take years,” Formenty said. “Right now, the need for information is of such urgency that even limited information will be helpful in taking the right control measures.”

He said closer regulation of wildlife trade and sales would contribute to blocking the spread of SARS.

In mainland China, 5,327 people were sickened and 349 died from the disease, with more than half of those in Beijing, the hardest-hit city in the world. The last two SARS patients were released from a Beijing hospital Saturday.

After an initially sluggish response to SARS, the Chinese government launched a massive campaign to persuade its citizenry and the world that it was taking the problem seriously.

“People are no longer so complacent that we are totally free from communicable diseases,” said Alan Schnur, a Beijing-based WHO official. “SARS has taught us that that these germs are out there and they can come at any time, so we always need to be prepared for that.”

On Thursday, state media said China would join hands with WHO to step up infectious disease control and prevent future SARS outbreaks through better training and education.

WHO and the Ministry of Health will jointly launch a program next month to train medical workers to prevent infectious diseases from spreading in hospitals, the China Daily newspaper reported.

The program will begin in Beijing and involve about 100 medical workers, it said, and additional training courses will later be held across the nation.

Foreign and Chinese disease experts will oversee the training program, which aims to educate thousands of hospital workers, the paper said.

Dr. Henk Bekedam, WHO’s China representative, said China has a “unique opportunity” to help the world understand and defeat SARS.

“Whether or not SARS returns, China must have a strong surveillance network already in place,” Bekedam said. “Investing now in this safety net may be the key to successfully combating SARS.”